术腔置入脱细胞异体真皮基质预防腮腺术后Frey综合征

Acellular Dermal Matrix Implantation in Operation Cavity for Preventing Frey’s Syndrome After Parotid Gland Surgery

目的探讨脱细胞异体真皮基质(acelluar dermal matrix,ADM)置入腮腺术腔预防腮腺术后Frey综合征的临床效果。方法将2010年1月~2018年3月89例腮腺手术按患者意愿分实验组(44例)和对照组(45例),实验组术腔置入ADM,对照组未置入任何组织材料。术后半年以调查问卷方式对患者有无Frey综合征症状、Frey综合征发生时间以及对生活的影响进行评价。结果实验组随访7~106个月,中位随访时间23.5月;对照组随访16~90个月,中位随访时间40个月。实验组腮腺手术后Frey综合征发生率2.3%(1/44),明显低于对照组42.2%(19/45)(χ^2=26.978,P=0.000)。20例Frey综合征经合理解释与沟通均未进一步治疗,4例(20%)认为Frey综合征对自己的生活无明显影响,其余16例(80%)认为Frey综合征对自己的生活影响较明显或非常明显。结论术腔置入ADM明显降低腮腺术后Frey综合征的发生率,具有满意的预防效果。

Objective To evaluate the clinical effect of acellular dermal matrix(ADM)implantation in operation cavity for the prevention of Frey’s syndrome after parotid gland surgery.Methods A total of 89 patients receiving parotid gland surgery from January 2010 to March 2018 were divided into either experimental group(44 patients)or control group(45 patients)according to patients’willing.The experimental group was implanted with ADM.The control group was not implanted with any tissue materials.The incidence rate of Frey’s syndrome,the time of Frey’s syndrome,and its impact on life were evaluated.Results The experimental group was followed up for 7-106 months(median,23.5 months).The control group was followed up for 16-90 months(median,40 months).The incidence of Frey’s syndrome in the experimental group was 2.3%(1/44),which was significantly lower than 42.2%(19/45)in the control group(χ^2=26.978,P=0.000).After reasonable explanation and communication,no further treatment was carried out for Frey’s syndrome in 20 patients.Four patients(20%)thought that Frey’s syndrome had no significant impact on their own lives,and the other 16 patients(80%)thought that Frey’s syndrome had significant or very significant impact on their own lives.Conclusion ADM implantation in operation cavity significantly reduces the incidence of Frey’s syndrome after parotid gland surgery,having a satisfactory preventive effect.